Health Insurance Coverage

Navigating Payer Denials: A Physician Advisor’s Perspective #2

A physician advisor recently described a case that should unsettle anyone who cares about fair, clinically grounded coverage decisions: a Medicaid patient arrived comatose from an overdose, was emergently intubated, developed aspiration pneumonia, and stayed through three midnights before leaving against medical advice. By any bedside standard, this is acute, unstable care—exactly what…

Inside ERISA Denials: Why Employers May Be the Real Decision-Makers Behind Your Insurance Card

Insurance denials aren’t new, but they’re hitting a breaking point right now. As prior authorizations surge and patients face longer delays for everything from imaging to specialty drugs, more providers are realizing that the “payer” on the card often isn’t the one truly holding the reins. A growing share of Americans are covered…

Health Plans are Now Covering New Weight Loss Drugs. This Can Help Fix the Obesity Epidemic

Widespread insurance coverage of breakthrough weight loss medications could redirect billions in healthcare spending from treating obesity-related diseases to p

FinFit: The Evolution of Employer-Sponsored Health Benefits

Employers are reimagining health benefits to address soaring deductibles and protect workers from rising out-of-pocket costs